WoMentoring Mentee Application

Once you have completed this application you will need to attach your resume. Both the application and the resume are required. Cohorts begin three times per year so there may be a delay in being contacted following the submission of your application. For questions, please contact [email protected]

Name *

Name

First Name

Last Name

Address *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number *

Phone Number

Country

(###)

###

####

Email *

Occupation *

Place of Employment *

Date of Birth *

Date of Birth

MM

DD

YYYY

How did you hear about the WoMentoring Program? *

Education Level / Degree(s) Earned *

Additional Training / Volunteer Experience *

List any supportive financial assistance you are currently receiving *

In what area/occupation would you like to be mentored and why? *

Please be as specific as possible

Do you have experience in that field? If so, describe/discuss. Are you re-careering? *

Have you had previous mentee experience? If so, explain *

Can you commit yourself to meeting with a mentor at least once a month for six months? *

Yes

No

What goals would you like to work on with your mentor? *

What life or career barriers have you faced? *

Other JVS Services/Resources that you are currently/have used *

Please select the professional skills that you would like to work on with your mentor during the six months of the program *